Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Cancer. 2010 Feb 15;116(4):940-8. doi: 10.1002/cncr.24747.
To assess trends in cancer, the authors evaluated the risk of 1 generation compared with that 25 years earlier (generational risk) for 3 groupings of cancers: those related to tobacco; those that reflect advances in screening or treatment; and a residual category of all other cancers.
In individuals ages 20 years to 84 years, age-period-cohort models were used to summarize time trends in terms of generational risk and average annual percentage change for US cancer incidence (1975-2004) and mortality (1970-2004) rates associated with these 3 cancer groupings.
Adult white men today developed 16% fewer tobacco-related cancers and had 21% fewer deaths because of those cancers than their fathers' generation, whereas adult white women experienced increases of 28% and 19%, respectively, relative to their mothers. The incidence of commonly screened cancers rose 74% in men and 10% in women, whereas mortality fell 25% in men and 31% in women. For cancers that have not been linked chiefly to tobacco or screening, the incidence was 34% and 23% higher in white men and white women, respectively, than in their parents' generation 25 years earlier. Mortality in this residual category decreased 14% in men and 18% in women. Results among blacks were qualitatively similar to those among whites.
Despite declining overall cancer death rates, adults are experiencing increased incidence of cancers that are not associated with tobacco or screening relative to their parents. Future research should examine whether similar patterns are exhibited in other modern nations and should identify population-wide avoidable risks that could account for unexplained increases in these residual cancers.
为了评估癌症趋势，作者评估了与吸烟有关的癌症、反映筛查或治疗进展的癌症以及其他所有癌症的风险在 1 代人与 25 年前（代际风险）相比的变化。
在年龄在 20 岁至 84 岁的个体中，采用年龄-时期-队列模型总结与这 3 种癌症组相关的美国癌症发病率（1975-2004 年）和死亡率（1970-2004 年）的时间趋势，具体形式为代际风险和平均年百分比变化。
与他们的父辈相比，现在的成年白人男性患与吸烟有关的癌症减少了 16%，死于这些癌症的人数减少了 21%，而成年白人女性患与吸烟有关的癌症的风险分别增加了 28%和 19%。常见筛查癌症的发病率在男性中增加了 74%，在女性中增加了 10%，而男性死亡率下降了 25%，女性死亡率下降了 31%。对于主要与吸烟或筛查无关的癌症，与 25 年前相比，白人男性和白人女性的发病率分别增加了 34%和 23%。在这个剩余类别中，男性的死亡率下降了 14%，女性的死亡率下降了 18%。黑人的结果与白人的结果基本相似。
尽管总体癌症死亡率在下降，但与他们的父母相比，成年人患与吸烟或筛查无关的癌症的发病率在增加。未来的研究应检查其他现代国家是否存在类似的模式，并应确定可解释这些剩余癌症增加的可避免的人群风险。
